What role does the stress response have in congestive heart failure?

This review is concerned with cardiac malfunction as a result of an imbalance in protein proteostasis, the homeostatic balance between protein removal and regeneration in a long remodeling process involving the endoplasmic reticulum (ER) and the unfolded protein response (UPR). The importance of this is of special significance with regard to cardiac function as a high energy requiring muscular organ that has a high oxygen requirement and is highly dependent on mitochondria. The importance of mitochondria is not only concerned with high energy dependence on mitochondrial electron transport, but it also has a role in the signaling between the mitochondria and the ER under stress.

Demographics, Clinical Characteristics, Management, and Outcomes of Acute Heart Failure Patients: Observations from the Oman Acute Heart Failure Registry.

Objectives: We sought to describe the demographics, clinical characteristics, management and outcomes of patients in Oman with acute heart failure (AHF) as part of the Gulf aCute heArt failuRe rEgistry (CARE) project.

Methods: Data were analyzed from 988 consecutive patients admitted with AHF to 12 hospitals in Oman between 14 February and 14 November 2012.

Results: The mean age of our patients was 63±12 years.

Outcomes of Cardiopulmonary Resuscitation and Estimation of Healthcare Costs in Potential 'Do Not Resuscitate' Cases.

Objectives: Cardiopulmonary resuscitation (CPR) is a life-saving procedure which may fail if applied unselectively. 'Do not resuscitate' (DNR) policies can help avoid futile life-saving attempts among terminally-ill patients. This study aimed to assess CPR outcomes and estimate healthcare costs in potential DNR cases.

Diclofenac-Induced Photo-Onycholysis.

Onycholysis is the detachment of the nail plate from the nail bed. If drug-induced, it can be an isolated phenomenon, but it may also accompany or follow a cutaneous phototoxicity reaction due to drug intake and exposure to ultraviolet irradiation. Photo-onycholysis is a rare photosensitivity reaction due to exposure to either a natural or artificial source of light.

Congenital cholesteatoma localized to the mastoid cavity and presenting as a mastoid abscess.

Introduction. Congenital cholesteatoma is a pearly white mass that rarely originates from the mastoid process. Case Report.

A surprising finding after external ear polypectomy in a deaf mute patient.

Introduction. External auditory canal polyps usually reflect an inflammatory process. Rarely, they may reflect a serious condition that warrants urgent intervention.

Osteoma presenting as a painless solitary mastoid swelling.

Introduction. Osteoma of the temporal bone is a very uncommon benign tumor of bone. Osteomas may occur in the external auditory canals but are reported to be very rare in the mastoid bone.

Bilateral pregnancy luteoma: a case report.

Pregnancy luteoma is a non-neoplastic lesion of the ovary occurring during pregnancy and is usually discovered incidentally at the time of a cesarean section or during postpartum tubal ligation. An accurate diagnosis is important for the mother and the fetus as it can be confused with ovarian malignancy leading to unnecessary surgery. We report a case of a pregnant female who was discovered to have bilateral enlarged ovaries at the time of emergency cesarean section.

Cytological diagnosis of collagenous spherulosis of breast.

Collagenous spherulosis is a rare entity usually seen in association with benign breast lesions. It is often picked up incidentally with a reported incidence of about 0.2% in cytological material.

Treating children without antibiotics in primary healthcare.

The overuse of antibiotics in children is becoming a major public health problem. Although most of the common childhood infections such as diarrhea and upper respiratory tract infections are caused by viruses, large volumes of antibiotics are prescribed for these infections in children in the primary care settings. Excessive use of antibiotics is the fundamental risk factor for the development of antibiotic resistance.

Rupture of Splenic Artery Aneurysm during Pregnancy: A Report of two Cases.

Splenic artery aneurysm (SAA) is a rare clinical entity that carries the risk of rupture and fatal hemorrhage. Ruptured SAA, especially during pregnancy has fateful consequences for the mother, foetus or both. The role of the Radiologist is very important in preventing mortality.

Carcinoma caecum--a rare presentation.

Caecal and right sided colonic cancers mostly present with fatigue, weakness and iron deficiency anemia. Such tumours rarely perforate posteriorly and involve the retroperitoneum. We report a case of an old Omani lady who came with insidious sign and symptoms of perforated caecum leading to retroperitoneal collection and necrotizing fasciitis of abdominal wall due to carcinoma of caecum.

Rapunzel Syndrome: A Case Report.

Rapunzel syndrome is a rare type of trichobezoar with extension of the hair into the small bowel. Clinical presentation can be deceptive ranging from upper abdominal mass to gastrointestinal obstructive symptoms. In majority of cases, the diagnosis is made very late in the history of the disease due to late patient presentation in lieu of his underlying mental disorder.

Caffey disease or infantile cortical hyperostosis: a case report.

Caffey disease or Infantile Cortical Hyperostosis (ICH) is a rare and mostly self limiting condition affecting young infants. It is characterized by acute inflammation of the periostium and the overlying soft tissue and is accompanied by systemic changes of irritability and fever. Diagnosis may be delayed as this disorder mimics a wide range of diseases including osteomyelitis, hypervitaminosis A, scurvy, bone tumors and child abuse.

Large Brunner's Gland Hamartoma: A Case Report.

Brunner's gland hamartoma is an extremely uncommon benign tumor of the duodenum. Most of the lesions are small, asymptomatic and are detected incidentally. It may rarely attain a large size and produces a variety of clinical manifestations.

A simple technique of inserting an intra-abdominal drain in laparoscopic surgery.

Objectives: We describe a simple technique for introducing any size of intra-abdominal drain in laparoscopy through a 3-5 mm port site without any of the drawbacks of other techniques practiced.

Methods: Setting is usually of a conventional laparoscopic surgery with various ports positioned depending on the procedure performed. At the end of theprocedure a 5 mm port site cannula is usually chosen to 'pull in' an intra-abdominal drain by railroading, under vision.

Ten-Year Retrospective Comparative Analysis of Laparoscopic Repair versus Open Closure of Perforated.

Background: Aim of this study was to compare the result of open and laparoscopic repair of perforated peptic ulcers in terms of operation time, postoperative pain, hospital stay, and wound infection.

Methods: Clinical notes of 152 patients who underwent the operative closure of perforated peptic ulcers from 1996 to 2006 were available for study. All patients were offered laparoscopic approach from 1998 onward.

Laparoscopic assisted two port open appendicectomy.

Objectives: The laparoscopic appendicectomy can be performed using one to several ports. We present our experience of two port laparoscopic assisted open appendicectomy. The objective was to assess the results retrospectively in terms of complications and its limitations.

An experience with 1000 consecutive cystic duct ligation in laparoscopic cholecystectomy.

Although rare, the clips are known to slip, dislodge, ulcerate, migrate, internalize, embolize, and give rise to necrosis of the cystic duct with resultant bile leak and other complications. Ligation of cystic duct has been practiced since long time with several modifications of intracorporeal and extracorporeal techniques. We have used a standard 'C' technique of intracorporeal knotting of cystic duct in 1000 consecutive patients of laparoscopic cholecystectomy.